Proposed Changes to Pharmacy Benefit Manager Regulations
March 13, 2026
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The Frame
The bill would have changed how patients access specialized medications by requiring PBMs to include specific essential providers, such as cancer centers and children's hospitals, in their networks and prohibiting mandatory mail-order requirements for most drugs.
Potentially affected actors named in the source documents. Mention is not a position.
Pharmacy Benefit Managers
The bill would have imposed new requirements on their provider contracts and restricted their ability to steer patients to affiliated pharmacies.
Patients
The bill would have changed their access to prescription drugs, including the ability to choose retail pharmacies over mail-order and the ability to receive drugs at specific essential provider sites.
Essential Providers (Cancer centers, children's hospitals, etc.)
The bill would have required PBMs to offer them provider contracts for the administration and dispensing of covered drugs.
Last recorded activity March 13, 2026.
Introduced.
Summary
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
What is a pharmacy benefit manager (PBM)?
Would this bill have forced me to use mail-order pharmacies?
Did this bill pass?
Why It Matters
The bill would have changed how patients access specialized medications by requiring PBMs to include specific essential providers, such as cancer centers and children's hospitals, in their networks and prohibiting mandatory mail-order requirements for most drugs.
News Coverage
Lobbying Activity
340B Health
2026
“The SECURE 340B Act (H.R. 9599); The Tax-Exempt Hospital Transparency Act (H.R.9504); 340B PATIENTS Act (H.R. 4581/S.2372); Community Health Center Drug Pricing Protection Act (H.R. 7391); 2027 OPPS Proposed Rule; Information Collection Request Title: 340B Rebate Model Pilot Program Application, Implementation, and Evaluation, OMB Number 0906-NEW; Manufacturer Demand for Access to in-House Pharmacy Claims Data; Lilly 340B Drug Pricing Denial; HRSA Rebate Model Pilot pending regulation; Pending Senate "Gang of Six" draft 340B legislation; FY27 Appropriations legislation; Pending introduction of updated and expanded Community Health Center Drug Pricing Protection Act.”
AARP
2026
“P.L. 119-21, One Big Beautiful Bill Act H.R. 8867, Planning for Long-term Aging Needs (PLAN) Act H.R. 5861, Legacy Act of 2025 H.R. 9393, the Lower Costs, More Transparency Act. H.R. 9396, the Prior Authorization Accountability Act. S. 4916, the Aging with Artificial Intelligence Act. H.R. 8100, Safe Staffing Saves Lives Act. S. 3886, Nurses Belong in Nursing Homes Act. H.R. 6766/S. 3492, the Essential Caregivers Act of 2025. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. S. 2120, the Older Americans Act Reauthorization Act of 2025 H.R. 5575, the Firefighters Assisting Seniors to Emergency Response (FASTER) Act of 2025. H.R. 3954/S. 4641, Improving Access to Medicare Coverage Act. H.R.5554/S.2831, Stand Strong for Medicare Act. S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act and efforts related to the bill S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act S. 668/H.R. 3183, Supporting Access to Falls Education and Prevention and Strengthening Training Efforts and Promoting Safety Initiatives (SAFE STEPS) for Veterans Act of 2025 CMS-1851-P, Hospice Proposed rule. CMS-1843-P, Skilled Nursing Facility Proposed rule. CMS-1844-P, Home Health Proposed rule. No bill number. Health care transparency. No bill number. Discussed use of artificial intelligence and health data technology. No bill number. Discussed health-related policies and activities around the fall respiratory virus season. No bill number. Discussed health insurance affordability proposals. No bill number. Discussed Nursing Home staffing standards, safety, and quality. No bill number. Discussed Nursing home transparency and ownership requirements. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed HUD Assisted Living Requirements No bill number. Discussed family caregiving. No bill number. Discussed AARP paper on Medicare Caregiver Training Services. No bill number. Discussed Medicaid community engagement interim final rule, including the family caregiver exemption. No bill number. Discussed the paid direct care workforce in long-term care. No bill number. Discussed the unaffordability of long-term care. No bill number. Discussed Money Follows the Person Rebalancing Demonstration Program and Medicaid HCBS spousal impoverishment protections. No bill number. Discussed Medicaid fraud and family caregivers, Medicaid self-direction programs. No bill number. Discussed sandwich generation family caregiver hearing and submitted a statement for the record discussing family caregivers and sandwich generation caregivers, programs that support them, AARP caregiving resources, and federal policies to support sandwich generation caregivers and caregivers more broadly. No bill number. Discussed long-term care. No bill number. CMS-2453-NC; Medicaid Program; 2028 Medicaid Home and Community-Based Services Quality Measure Set Submitted comments No bill number. Discussed expanding access to home care. No bill number. Discussed the increasing cost of home care No bill number. Discussed HSA use for telehealth chronic care management services/subscriptions. No bill number. Discussed artificial intelligence and technology”
CAPITOL ADVOCACY
on behalf of CALIFORNIA RETAILERS ASSOCIATION
FEROX STRATEGIES
on behalf of FRESENIUS KABI USA LLC
MARSHALL & POPP, LLC
on behalf of ABBVIE INC.
FAEGRE DRINKER BIDDLE & REATH LLP
on behalf of NATIONAL ASSOCIATION OF BOARDS OF PHARMACY
HORIZONS GLOBAL SOLUTIONS LLC
on behalf of ASTERES
PITTMAN LAW GROUP
on behalf of TRULIEVE
ZIRKELBACH STRATEGIES
on behalf of WALGREEN CO.
FEROX STRATEGIES
on behalf of ATRIUM THERAPEUTICS
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
PBM Network Restriction
The bill represented a legislative attempt to curb the vertical integration of PBMs by prohibiting the steering of patients to affiliated pharmacies.
Connected Entities
Sources
openstates.org
Analysis Score
0–100- Significance65How much this matters to a regular citizen
- Controversy40Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz10Current news / social attention level
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